摘要
目的对高血压性脑出血术后再手术的原因进行临床研究,为以后的临床工作提供理论及实践依据。方法回顾性分析我院自2002年2月～2011年6月所有因高血压性脑出血行手术治疗213例,其中因各种原因再次手术治疗36例的临床资料。结果因颅内再出血再次行手术治疗29例,因大面积脑梗塞再次行手术治疗7例。再出血再手术组患者的GOS结果提示,Ⅰ～Ⅲ级者明显多于再出血未再手术组,差异有显著统计学意义(P<0.01);GOSⅣ者差异无统计学意义(P>0.05);GOSⅤ级者明显少于未再手术组,差异有显著统计学意义(P<0.01)。脑梗塞再手术组患者的GOS结果提示,Ⅰ～Ⅲ级明显多于脑梗塞未再手术组,差异有统计学意义(P<0.05);GOSⅣ级者,差异无统计学意义(P>0.05);GOSⅤ级者明显少于未再手术组,差异有显著统计学意义(P<0.05)。结论术前认真评估患者的整体状况,手术切口的选择,手术的规范化操作,术中及术后规范化治疗以及避免医源性损伤都是防止因再出血和脑梗塞而再手术的关键。
Objective To explore the reoperation causes for hypertensive cerebral hemorrhage,so as to provide theoretical and practical basis for the future clinical work.Method The clinical data of 36 patients with reoperation out of 213 patients who received surgical operation for hypertension cerebral hemorrhage in our hospital from February 2002 to June 2011 were reviewed and analyzed.Results There were 29 cases of rebleeding and 7 cases with a large area of cerebral infarct received reoperation.In the reoperation group of rebleeding patients,the rate of Ⅰ~Ⅲ GOS stage was obviously higher than the non-reoperation group（P0.01）.The Ⅳ stage had no significant difference（P0.05）.And the rate of Ⅴ stage was much lower（P0.01）.In the reoperation group of cerebral infarct patients,the rate of Ⅰ~Ⅲ GOS stage was obviously higher than the non-reoperation group（P0.05）.The Ⅳstage had no significant difference（P0.05）.And the rate of Ⅴstage was much lower（P0.05）.Conclusion Careful evaluation of the overall condition,suitable surgical incision,standardized operation and treatments are the key points to avoid iatrogenic injury in the operation of hypertension cerebral hemorrhage.
出处
《中国现代手术学杂志》
2012年第1期57-60,共4页
Chinese Journal of Modern Operative Surgery
关键词
脑出血
高血压
再手术
格拉斯哥预后评价
预后
cerebral hemorrhage
hypertension
reoperation
Glasgow outcome scale
prognosis
